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Pharmacology > Pharm 9.2 > Flashcards

Pharm 9.2 Flashcards

1
Q

Epinephrnien on SM in GIT

A

relaxation, peristalsis is reduced and sphincters are constricted

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2
Q

Epi on SM in Bladder

A

trigone and sphincter contricted (alpha 1 rec), detrusor relaxed (beta 2), net effect is urinary retentino

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3
Q

Epi on SM in uterus

A

relaxation at term (tocolysis - lysis of contraction of the uterus so no risk of premature delivery)

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4
Q

dialation of puple

A

alpha 1 agonist on radial muscles

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5
Q

constriction of pupil

A

M3 muscaranic agonis on sphincter pupallae

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6
Q

uses of Epinephrine

A

bronchospasm, anaphylactic shock, local anaesthetics, glaucoma, cardiact arrest

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7
Q

Epi in bronchospasm

A

primary drug used in emergency due to acute attacks of asthma

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8
Q

Epi in anaphylactic shock

A

drug of choice, can increase BP in deadly hypotension and increase respiratory exchange

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9
Q

what is the durg of choice in anaphylactic shock

A

epinephrine

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10
Q

epi with local anaesthetics (adjunct)

A

1/100, 000 parts, increase duration of action of local anaesthetic due to alpha 1 and beta 2 effects (low dose beta 2) (Epinephrine + Lidocain)

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11
Q

epi with glaucoma (open angle)

A

decrease IOT due to decreased production of aqueous humor by vasoconstriction of ciliary body blood vessels (2% eyedrop)

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12
Q

Prodrug for glaucoma

A

Dipivefrin - rarely used

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13
Q

epi with cardiac arrest

A

to restore cardiac rhythm in patients with cardiac arrest or heart block regardless of cause

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14
Q

Epinephrine adverse effects

A

palpitation, restlessness, tremors, increase in BP, arrhythmia, cerebral hemorrhage (due to marked elevation of BP)

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15
Q

when is epinephrine contraindicated

A

angina pectoris

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16
Q

epinephrine interactions

A

hypertyroidism, cocaine, diabetes, beta blockers

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17
Q

epinephrine, norepinephrine, and dopamine are orally

A

inactive

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18
Q

duration of action of epinephrine

A

rapid onset but a brief duration of action (due to rapid degradation)

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19
Q

epinephrine and norepinephrine are degraded by

A

MAO and COMT of the intestine wall and liver

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20
Q

treat hyperthyroidsm by

A

using a beta blocker to block the hyper adrenergic state

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21
Q

how does cocain affect epinephrine

A

inhibits its reuptake

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22
Q

betablockers given with epinephrine

A

only left wth alpha 1 effects causing vasoconstriciton

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23
Q

Epinephrine can be given

A

IV, intracardiac, inhalational, subcutaniously, endotracheal tube, or topically

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24
Q

Norepinephrine activates

A

all but BETA 2, more alpha effects causing vasoconstirction, reflex bradycardia

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25
Q

NE on TPR

A

inc TPR due to vasoconstriction of most of the vascular beds

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26
Q

NE on systolic and diastolic BP

A

increase

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27
Q

NE on pulse rate

A

decrease pulse rate (reflex bradycardia) due to inc in BP, reflex rise in vagal activity by stimulating barroreceptors, decrease heart rate, decrease pulse rate

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28
Q

If atropine is given before NE

A

it will result in tachycardia

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29
Q

NE on alpha 1 receptors

A

inc TPR, inc BP (potential reflex bradycardia)

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30
Q

NE on beta 1 receptors

A

inc HR, inc SV, inc CO, inc pulse pressure

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31
Q

Difference btw high does epinephrine vs NE in reversing hypertension

A

if you are to use an alpha 1 blocker to reduce vasoconstirctin, epinephrine continues to work on beta 2 receptors that results in hypotension, but NE do not work on beta 2 receptors

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32
Q

Isoproterenol

A

direct acting synthetic catecholamine, nonselective beta agonist

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33
Q

isoproterenol on beta 1 receptors

A

increased contractility and heart rate

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34
Q

isoproterenol on beta 2 receptors on heart

A

decrease in TPR, decrease in mean BP

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35
Q

isoproterenol overall effect on heart

A

systolic blood pressure does not fall significantly as diastolic due to beta 1 receptor action so the pulse pressure decreases

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36
Q

activation of beta 2 in the lungs and GI and uterus

A

relaxation of SM

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37
Q

Isoproterenol is used in

A

bronchospasm, heart block, bradyarrhythmias

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38
Q

dopamine acts on

A

D1, D2, alpha, and beta receptors

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39
Q

D1 in the renal and mesenteric blood vesses

A

dialates - most sensitive at low dose

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40
Q

moderate high dose dopamine

A

positive iontropic action on the heart by beta 1

41
Q

high dose dopamine

A

vasoconstriction on alpha 1 receptors

42
Q

as the dose increases the binding of dopamine follows

A

D1 –> beta 1–> alpha 1

43
Q

the shape of the dose response for natriuresis curve of dopamin is

A

an inverted U

44
Q

natrieurisis and dopamine

A

both natriuretic and diuretic

45
Q

dopamine increases

A

myocardial contractility, RBF, GFR, sodium excretion, urine output

46
Q

Dopamine in cardiogenic shock is the drug of choice bc

A

increases BP by stimulating heart (beta 1), increasing perfusion to kidney and splanchnic areas (through D1 receptors) by vasodialation, increases blood flow to the kidney, increases GFR, increases Na+ diuresis, prevents kidney shutdown

47
Q

Dopamine agonists

A

fenoldopam, dopexamine

48
Q

dobutamine is a

A

selective beta1 agonsit, increases the force of contraction of the heart, with little change in HR,

49
Q

why is do butamine a major advantage over other sympathomimetic drugs

A

used in CCF, MI with failure bc it increases CO without elevating the oxygen demand of myocardium - am major advantage over other sympathomimetic drugs (which work at the expense of oxygen)

50
Q

alpha 1 selective agonists

A

phenylephrine, methoxamine

51
Q

Phenylephrine is a

A

specific alpha 1 agonist direct acting noncatecholamine, increases the mean blood pressure viea basoconstriction with minimal effect on pulse pressure, increasein BP can elicit reflex bradycardia, no direct effect on heart

52
Q

Phenylephrine is used in

A

nasal decongestion, mydriasis, to retard absorption of local anesthetics, to raise BP and to terminate episodes of supraventricular tachycardia (esp Methoxamine)

53
Q

alpha 2 selective agonists

A

clonidine, methyldopa

54
Q

clonidine is a

A

alpha 2 selective agonist

55
Q

clonidine acts centrally to produce

A

inhibition of sympathetic vasomotr centers, decreaseing sympathetic outflow to the periphery

56
Q

clonidine bioavailability

A

excellent (transdermal patches also available)

57
Q

Clonidien adverse effects

A

dry mouth, sedation, bradycardia, sexual dysfunction, rebound hypertension (following abrupt withdrawal of clonidine)

58
Q

uses of clonidine

A

used in hypertension (to lower BP because of its central actions), also used to minimize the symptoms associated with opiates or benzodiazepines withdrawal

59
Q

other alpha 2 agonists

A

guanfacine, guanabenz, methyldopa (HTN in pregnancy), Tizanidine (spasmolytic)

60
Q

Methyldopa is used for

A

hypertention in pregnancy

61
Q

Tizanidine is used as a

A

spasmolytic

62
Q

topical direct acting sympathomimetics

A

naphazoline, oxymetazoline, xylometazoline

63
Q

Naphazoline is used as

A

a topical vasoconstrictor - nasal decongestant

64
Q

Oxymetazoline is used to

A

reduce congestion and swelling of th nasal mucosa - nasal decongestant

65
Q

xylometazoline is used as a

A

nasal decongestant

66
Q

indirect acting sympathomimetci drugs

A

amphetamine, tyramine, ephedrine (mixed action)

67
Q

amphetamine is a

A

noncatecholamine sympathomimetic drug

68
Q

amphetamine function

A

increases the release of NE, dopamine in synaptic spaces

69
Q

Amphetamine is taken

A

orally

70
Q

Amphetamine and CNS

A

has prominent CNS stimulatory action, increases alertness, concentration and wok capacity

71
Q

Amphetamine on RAS

A

activates reticular activating system producing insomnia

72
Q

Amphetamine on CVS

A

increases BP and HR

73
Q

Therapeutic uses for amphetamine

A

CNS stimulant in the treating ADHD, Narcolpecy (esp Modafinil, a new amphetamine substitute), Obesity (appetite control/appetite suppression)

74
Q

Tyramine releases

A

large amounts of stored CA from nerve terminals

75
Q

is Tyramine used clinically

A

no

76
Q

Tyramine is found in

A

fermented foods, such as aged/riped chees, meats, chicken liver, pickled or smoked fish such as anchovies or herrings, and red wines

77
Q

Tyramine is inactivated by

A

MAO in the gut

78
Q

Tyramine can participate in

A

the “cheese reaction”

79
Q

Cocain use

A

local anesthetic agent, having ability to block uptake of NE in the adrenergic neurons; concequently NE accumulates in the synaptic space resulting in enhancement of sympathtic activity. Also a CNS stimulant and drug of abuse.

80
Q

Mixed acting drugs

A

ephedrine, pseudoephedrine

81
Q

Ephedrine/pseudoephedrine is an

A

alkaloid from the plant Ephedra vulgaris

82
Q

repeated injections of ephedrine produce

A

tachyphylaxis

83
Q

Ephedrine is resistnat to

A

MAO and COMT

84
Q

Ephedrine is effective taken

A

orally and crosses the BBB - CNS stimulation

85
Q

Ephedrine uses

A

bronhial asthma (not really no) and nasal congestion

86
Q

Phenylpropanolamine is an

A

alpha agonist

87
Q

Phenylpropanolamine is used as a

A

nasal decongestant, may cause severe hypertension

88
Q

Phenylpropanolamine is unsafe because

A

it causes strokes in women

89
Q

Drugs having selective beta 2 action

A

albuterol, pirbuterol, salmeterol, foroterol, terbulatine, metaproterenol

90
Q

Tocolytic agents

A

Ritodrine, Terbutaline (beta 2 agonist)

91
Q

Tocolytic agents work by

A

relaxing the pregnant uterus and supressing premature labor

92
Q

chart on 108

A

look at it, mostly tells you cateholamines have no oral activity, but other sympathomemetics do except pehnylephrine and cocaine and the sympathomimetics take hours to work, while catecholamines take minutes

93
Q

Pressor agents

A

NE, Dopamine

94
Q

Cardiac stimulants

A

Epinephrine, Isoproterenol, Dobutamine

95
Q

Bronchodialators

A

Epinephrine, Isoproterenol, Albuterol

96
Q

Nasal decongestants

A

Ephedrine, Pseudoephedrine, Phenylpropanolamine, Oxymetazoline, Xylometazoline

97
Q

CNS Stimulants

A

Amphetamine, Ephedrine

98
Q

Uterine relaxants

A

Isoxsuprine, Terbutaline, Ritodrine

Pharmacology (15 decks)

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